TY - JOUR
T1 - Interaction of healthcare staff’s attitude with barriers to physical activity in hemodialysis patients
T2 - A quantitative assessment
AU - on behalf of the Gruppo di Studio “Esercizio fisico nel paziente con insufficienza renale cronica” of the Società Italiana di Nefrologia
AU - Regolisti, Giuseppe
AU - Maggiore, Umberto
AU - Sabatino, Alice
AU - Gandolfini, Ilaria
AU - Pioli, Sarah
AU - Torino, Claudia
AU - Aucella, Filippo
AU - Cupisti, Adamasco
AU - Pistolesi, Valentina
AU - Capitanini, Alessandro
AU - Caloro, Giorgia
AU - Gregorini, Mariacristina
AU - Battaglia, Yuri
AU - Mandreoli, Marcora
AU - Dani, Lucia
AU - Mosconi, Giovanni
AU - Bellizzi, Vincenzo
AU - Di Iorio, Biagio Raffaele
AU - Conti, Paolo
AU - Fiaccadori, Enrico
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Background and aim of the study In hemodialysis patients, sedentarism is a potentially modifiable mortality risk factor. We explored whether healthcare staff’s attitude towards exercise interacts with patient-perceived barriers in modifying the level of physical activity in this population. Methods In this prospective, cross-sectional, multicenter study we recruited 608 adult patients and 330 members of the healthcare staff in 16 hemodialysis units in Italy. We assessed patient-perceived barriers to, and healthcare staff’s attitude towards, exercise by specific questionnaires. We fitted multilevel linear models to analyze the relationships of either barriers or staff’s attitude, and their interaction, with a measure of patient self-reported physical activity (the Human Activity Profile–Adjusted Activity Score [HAP-AAS]), adjusting for multiple confounders. We also employed latent class analysis to dichotomize patients into those endorsing or not endorsing barriers. Results Most barriers were negatively associated with the HAP-AAS (adjusted change attributable to a given barrier ranging between -5.1 [“Feeling too old”, 95% Confidence Interval: -9.4 to -0.8] and -15.6 [“Ulcers on legs and feet”, 95%CI: -24.8 to -6.5]. We found a significant interaction between staff’s attitude and barriers (adjusted P values ranging between 0.03 [“I do not believe that it is physician’s or nurse’s role providing advice on exercise to patients on dialysis”] and 0.001 [“I do not often ask patients about exercise”]). A beneficial effect of a proactive staff’s attitude was evident only in patients not endorsing barriers. Conclusions Barriers and non-proactive staff’s attitude reduce physical activity in hemodialysis patients. Patients not endorsing barriers benefit the most from a proactive staff’s attitude.
AB - Background and aim of the study In hemodialysis patients, sedentarism is a potentially modifiable mortality risk factor. We explored whether healthcare staff’s attitude towards exercise interacts with patient-perceived barriers in modifying the level of physical activity in this population. Methods In this prospective, cross-sectional, multicenter study we recruited 608 adult patients and 330 members of the healthcare staff in 16 hemodialysis units in Italy. We assessed patient-perceived barriers to, and healthcare staff’s attitude towards, exercise by specific questionnaires. We fitted multilevel linear models to analyze the relationships of either barriers or staff’s attitude, and their interaction, with a measure of patient self-reported physical activity (the Human Activity Profile–Adjusted Activity Score [HAP-AAS]), adjusting for multiple confounders. We also employed latent class analysis to dichotomize patients into those endorsing or not endorsing barriers. Results Most barriers were negatively associated with the HAP-AAS (adjusted change attributable to a given barrier ranging between -5.1 [“Feeling too old”, 95% Confidence Interval: -9.4 to -0.8] and -15.6 [“Ulcers on legs and feet”, 95%CI: -24.8 to -6.5]. We found a significant interaction between staff’s attitude and barriers (adjusted P values ranging between 0.03 [“I do not believe that it is physician’s or nurse’s role providing advice on exercise to patients on dialysis”] and 0.001 [“I do not often ask patients about exercise”]). A beneficial effect of a proactive staff’s attitude was evident only in patients not endorsing barriers. Conclusions Barriers and non-proactive staff’s attitude reduce physical activity in hemodialysis patients. Patients not endorsing barriers benefit the most from a proactive staff’s attitude.
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U2 - 10.1371/journal.pone.0196313
DO - 10.1371/journal.pone.0196313
M3 - Article
AN - SCOPUS:85046076290
VL - 13
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 4
M1 - e0196313
ER -